Would you let someone else to administer your meds? - page 3
Would/Do u let another person ( Aid, PCA, TCA) to administer your meds, adjust O2, etc?... Read More
May 29, '02Joined: Jun '01; Posts: 430Would any one let a nurse aid give a patient lactulose that was ordered?
May 29, '02Joined: Oct '00; Posts: 10,236; Likes: 64Originally posted by ohbet
Would any one let a nurse aid give a patient lactulose that was ordered?
May 29, '02Joined: Jul '01; Posts: 2,151; Likes: 86Slightly off subject, but are any of you concerned at how easy most systems make it to 'pinch' or steal narcotics? Especially the vial/ampule kind or leftover narcotic drips? (I.E., Versed, Morphine, Ativan, Fentanyl drips, etc.) I am new and super-paranoid about meds, including narcotics, and have been shocked to see how easy it would be to take something without getting caught. We regularly throw leftover drips away, and those could easily be snatched up by omeone else, not to mention drawing up IV narcotics (I won't give anyone ideas, but I'm sure you know what I'm saying here...). The whole thing just makes me nervous- and here we are, responsible for signing off on other peoples wastes and excesses. How do you all feel about this?
May 29, '02Occupation: RN Joined: Jan '02; Posts: 1,732; Likes: 1never sign a waste unless you saw it. sorry but all the nurses i worked with understood my simple rule. If I didn't see I wasn't signing for it.
May 29, '02Occupation: RN, CLNC, Entrepreneur Joined: Apr '01; Posts: 6,312; Likes: 106Ditto:
never sign a waste unless you saw it. sorry but all the nurses i worked with understood my simple rule. If I didn't see I wasn't signing for it.
My license, reputation, and livlihood depend on being honest.
May 29, '02Joined: May '02; Posts: 827; Likes: 42No way, not this mean old nurse. I can get into trouble without going out and looking for it!!
May 29, '02Occupation: Regulatory Nurse Consultant Joined: May '02; Posts: 24; Likes: 2Not a chance
May 29, '02Joined: Apr '02; Posts: 41; Likes: 11As a nursing student, we give meds to other nurses' patients. However we have to assess the patient first (AP w/Dig...etc..) and have to have all info about drugs we are giving and when we give them, it is our fault if anything happens, NOT the RN's (which would be very unfair anyway). Our clinical instructor is always checking and asking questions and making sure we know what we are doing.
Anyway, I believe this is a totally different subject from the original question. But just in case and to add to Moonshadeau's comments....)
May 29, '02Occupation: NICU RN Joined: Oct '00; Posts: 2,537; Likes: 369Originally posted by KristiWhite2377
Slightly off subject, but are any of you concerned at how easy most systems make it to 'pinch' or steal narcotics? How do you all feel about this?
May 29, '02Occupation: RN Joined: Oct '00; Posts: 337; Likes: 5When wasting leftover or partially used doses of narcotics, you must actually see the drug wasted in a manner in which it can not be retrieved. For fluids, pour it down the drain and run the water. If it is in a vial, draw it up with a syringe and squirt it down the drain. If it is leftover in a syringe, again squirt it down the drain. A leftover drip bag should be cut and emptied down the drain. Tablets or pieces of same should be dropped in the sink, pushed thru the drainholes, and flushed with water.
For used med patches (duragesic etc) flush down the toilet. NEVER in the garbage or even a sharps container. And guess what-desperate people STEAL from used sharps containers! Theyy are too desperate to wory about being stuck. So never drop a partially full vial of a controlled substance in a sharps container. It is not only asking for trouble, but is not considered a legal & legitimate means of narcotics disposal.
As others have said NEVER under any circumstances even your bestest friend from childhood, sign that you witnessed a waste unless you witnessed it irretrievably wasted.
I attended a one hour seminar by a former DEA agent and if you want to find a sure way to lose your license-mess with narcotics. And innocent carelessness tops the list! I was a real eyeopener to find that what so many of us do on a daily basis could actually close down a hospital in fines. We become so complacent when we deal with narcs-but we need to remember how desperate people take desperate measures and to safe guard our licences.
As far as letting another administer my meds-NO with slight exceptions. Working per diem, I don't always have time to develop a rapport with certain patients-especially the confused or developmentaly disabled. These people have already established a relationship with the full time CNA, however. So I have on rare occasions prepared meds, and then WHILE STANDING THERE, allowed the CNA to hand them to the patient while I watched, if I could not convince the patient to take the meds any other way. I don't believe in charting "refused" when a patient is not competent to refuse, so i will do everything in my power to convince the patient that the meds are needed and why. If that fails and they willingly take them from the CNA's hand while I watch, I have allowed it, and watched until everything was swallowed. I'm not advising this however, as i have no idea if it's legal (I doubt it!)-I'm just confessing! Of course, if all else fails, I have to chart refused and let the doc know-I don't mean to imply I would FORCE meds on anyone!
May 29, '02Occupation: once a manager, now a staff nurse, preceptor, educator and practice member Specialty: 30 year(s) of experience in NICU, PICU, PACU ; From: FAM ; Joined: Mar '01; Posts: 2,797; Likes: 3,172I have helped out others nurses, but our stuff comes from pharmacy and is labeled, so I don't have to worry about what is in a syringe. But, as for an unlicensed person...uh, how many ways can I say no!!!
May 29, '02Joined: Apr '02; Posts: 38,750; Likes: 16,271Nursing Student situations are a bit different than what we are talking about here. Students medicate people under the auspices and privileges of their INSTRUCTOR'S LICENSES, and this practice is therefore, LEGAL......the instructor at our school signed the MAR along w/the student and double-checked the 5 rights w/them when it was being administered. So, you are NOT really "medicating patients in place of the RN/LPN" this way.
I still say, letting an unlicensed person doing ANYTHING WITH meds or o2 is not only dangerous but *wrong*. Even o2 is considered a "drug" in the medical arena. And, if I did not draw it up, I don't give it, even if it WAS drawn up by another RN/LPN.......never.Last edit by SmilingBluEyes on May 29, '02
May 29, '02Occupation: research nurse Joined: Oct '01; Posts: 1,878; Likes: 44Weighing in again.
Thisnurse saidwhats wrong with another RN giving your meds if THEY draw them up and THEY chart that THEY gave them?
Student nurses are also another situation. They are actually practicing under their clinical instructor's license! They sign off on all the meds that students give.
Indeed has a really valid concern about narcotics. I worked on a floor where we had to use a lot of narcs. PCA's and epidurals and the whole 9 yards. The procedures are set up to handle any questions along those lines - two nurses receive it, two nurses sign that they've checked the orders.... You're right - the wasting is where it all falls down, sometimes. We always had to measure any waste, and I'd always bring the whole thing along, and make the other nurse witness me taking the fluid out of the PCA bag, measure it, note the amount, and waste it!! And I feel like that pretty much covers my butt on that score. But thinking about it from the point of view of someone who WANTED to divert narcotics, what's to keep them from taking the narc out while the bag is still hanging, replace the volume with NS and then go for a witness? Nuttin, honey.
I had an incident where I spazzed out when I was drawing up demerol for an IM injection. I bobbled the vial, the syringe was full, the needle was exposed, it touched the skin of my belly as it went to the floor. Stuck into the carpet like a lawn-dart!! Spoinggggggggg.
I freaked, of course. I made another nurse that was in the hallway at the time go with me to look at my belly (heh heh) and sign the incident report AND witness the waste - I wanted all of it witnessed by the same nurse. Then I made her go with me to the charge nurse, and I told her I needed a blood draw for demerol. I actually had to insist on the blood draw! Oh, they were both pretty peeved at me. But too bad, you know? Politicians are always talking about "The appearance of impropriety" but nurses REALLY have to be careful.